The Thyroid Connection; A Felicitous Feline; Challenging the Pain of De feet.

As September of 2016 wore on I was making slow progress, with the help of the online self-management program awareness exercises. In particular, there was a short “letting go” practise I did daily. I’d listen to this recording mid-morning on my iphone, lying on my side in bed, soothed by the touch of cotton sheets and a duvet. A soft, clear woman’s voice drew the listener’s attention to thoughts and emotions as well as physical sensations. “Make space for inner peace,” she said. It was her patient, humble tone, as much as her words, that helped me relax. In addition, her American Eastern seaboard accent reminded me of my birthplace. The familiar was comforting.

After this body scan, I’d trundle into my office with a cup of decaf and a cookie to check email. Periodically I’d glance at Dr. John Sarno’s 12 self-talk reminders, which I’d pinned on the wall, another strand of my healing plan. “The pain is due to TMS, not structural issues.” Did I really believe that? I wasn’t even sure I had the condition he called “Tension Myositis Syndrome”, but I sure had a hell of a lot of tension. And after proving I could lower the pain with thought or emotion, I no longer believed that structural issues in my spine were causing most of my pain. Maybe they played some part, though.

On September 13th, I noted in my diary: “Pain much less today — mostly L glute.” I got so excited at feeling better that I forgot to pay attention to my body, tensed up and started to hurt. I’d always been excitable. But for over a year now I’d been getting wound up much more easily. All day long my thoughts raced and my mood rose and fell — not a lot, I didn’t believe I was turning bi-polar, but my emotional temperature was certainly fluctuating more rapidly than the gently waving limbic ride I usually experienced in a day.

What was going on?

A host of other odd symptoms had cropped up, too. At night I’d wake up numerous times, intensely irritated by a scorching dry heat. Hot flashes? It didn’t feel like that. At age 28, chemotherapy for Hodgkins Disease had played havoc with my hormones, and hot flashes, exhaustion and depression had been part and parcel of that picture. This was the opposite. My heart pounded and I felt jittery, speeded up, and vaguely robotic. Plus, every morning when I teetered out of bed my body felt as tight and sore as if I’d been climbing mountains all night. It looked like it, too. How could muscles be so taut, given so much time lying around in bed? And when had my glossy, wavy hair become so dry and limp?

One night, tossing the covers off in a fury around 4 a.m., I remembered something. Just over a year ago, my GP had put me on medication to correct a slightly slow thyroid. Had he run any tests since? I couldn’t remember.

Feeling foolish, shaken and relieved, I slid back under the covers. Was my year in Hell due to an undiagnosed thyroid problem?

“Yes,” my GP nodded solemly, “it could be your thyroid.”

“I already stopped taking Synthroid.”

He handed me a requistion for bloodwork, and as I walked out of the office I wanted to raise a fist in victory. Now, I’d soon go back to normal!

First, though, a trip to a lab off-island was required. This meant sitting in a car. Sitting scared me silly, because it increased the pain and tightness in my lower back. “I can’t stand it if my back goes out again!” I thought as I steeled myself for a gruelling journey.

My husband drove. He had an appointment for dental work, so we’d get the blood test done, then drive to his appointment. I could lie down in the back if the pain got really bad.

We made it to the lab. But as we returned to the car, the “clunk” sensations and spiky pain that had heralded previous back spasms began. We were facing a half an hour drive to the dentist.

“Pull over!” I ordered.

“Why?”

“Just do it!”

My husband wasn’t used to being bossed around in this imperious tone. Even I was shocked by how I sounded.

He stopped the car.

“Here’s what’s going to happen. You’re going to drop me at a motel. Then, you go to the dentist and pick me up afterwards.”

“Is that really what you want?”

I gritted my teeth to keep from exploding. I was just barely keeping it together. We paid for a minimum 24-hour stay at a motel, and after reassuring Joe I was okay, he drove off.

I was not okay. I couldn’t force my thoughts into any of the calming, reassuring places I’d trained them to go, and I felt my mind splinter, like a broken jigsaw puzzle.

Great. Now I was sick in the head as well as the body.

Never in my life had I felt so scared and out of control. I climbed into the bed in terror and sobbed. Releasing emotion could be soothing, so I turned on the TV and then the radio, but no song or movie could distract my thoughts from darkness and fear. Was this what people in psychiatric wards experienced? I felt an empathy and understanding for sufferers of nervous illness I’d never known before. I stuck my earbuds in and listened to body scans as I waited for Joe.

A few hours later he was back, looking to me like a veritable knight in shining armor. But as we drove to the ferry the anxiety ramped up and I borrowed a cellphone from a stranger in the ferry lineup to call our local drugstore. Would they ask my GP to prescribe Ativan? We could pick it up on our way home.

Only once had I ever requested a drug for anxiety. It was years ago, when I was doing a Bachelors program in Creative Writing. My story was due for workshopping — fair game for 16 sharp minds — and I was jittery with nerves as Joe and I sat down for lunch at a Greek deli. I ordered a decaf Greek coffee with my spanakopitta, but ten minutes later, as I climbed the stairs to the classroom, I started shaking and realized I’d just been given the equivalent of a triple espresso.

By midnight, still shaking, I asked Joe to phone my GP, who prescribed Ativan. It did wonders. The thought of that calming little pill got me through now as I lay in the back of the car, cuddling a stuffie and talking back to a sneering inner voice which said, “Shame on you!” and “Act your age!”

“I knew you weren’t the type to get addicted,” my GP said kindly. It was true, and though I longed for the relief of Ativan, after three pills in 24 hours, I stopped. At home, I knew I could manage.

The test results had come back normal.

However, the symptoms continued.

“When will they stop?” I asked.

The doctor shrugged. “They could go on for months.”

Okay. At least I had an answer. The repeated back spasms, anxiety, tension, the pounding heart and racing thoughts had all been caused by an overactive thyroid. Heck, I’d beat cancer! I could deal with a little thyroid problem.

Triumphantly, I emailed Neil Pearson, and all the other practitioners I’d seen since 2015, when the spasms began — two athletic therapists, a massage therapist, and a yoga teacher — and told them the pain was caused by a hyperthyroid condition which had made my muscles really tense.

Little did I know. There was a long road ahead.

One thing that helped me calm down, or rather, one of the creatures that helped, was our cat, Simone. We’d inherited this small black feline, complete with French name, from the previous owner of the house. She’d never let her inside, and we didn’t let her in either, as Joe was allergic. But she’d watch us through the glass doors in the kitchen, and at any moment in the day a furry face might pop above the bottom of the doors’ wooden frame and a paw appear, scratching at the glass.

I was a sucker for Simone. Four years ago, she’d been a powerful added incentive for me in our decision to buy the house. People who don’t like cats find this very funny. But not only did I fall for the cat, I knew that joy was very important for people in pain. Working with Pearson’s techniques in 2012, I’d learned how it released powerful endorphins and other mood-lifting chemicals into the bloodstream, opening what Australian pain physiotherapist David Butler calls our “natural medicine cabinet”, and I was bargaining that my love for Simone would eventually trump the pain of picking up twelve-pounds of purring kitty. If I could gather her into my arms repeatedly my back would get stronger and maybe it would stop hurting. The cat would help me recover from decades of upper back pain.

My gamble paid off. Months went by before I dared, but one day I bent down and scooped her up. My upper back felt like it was on fire, but it was worth it to have Simone drooling with happiness in my arms. Four years later, I could pick her up and feel no pain at all.

That pain had for the most part become a distant memory. Sometimes it would flare up but I knew how to make it calm down with self-talk, breathing and body awareness, and love — all the tools in Pearson’s kit. But now lower back spasms prevented me from picking up Simone.

I hated that I could no longer bend down to lift the cat. However, cats like to jump up on things and I could lift her off the barbeque she liked to sit on and stroll along the deck, enjoying the warm vibrations of her purr against my chest. Even when I was inside, the mere sight of Simone sitting on the barbeque, tail curling gently around her and eyes blinking sleepily — a sign of affection, it’s said — softened my heart, and my body began to relax. The cat was good medicine.

Stroking her fur, the way she put her paws around my neck and butted my chin affectionately when I held her, all this sent healing vibrations through my whole body. I’d always thought “good vibrations” was just a silly phrase popularized by The Beach Boys, but now, I knew it wasn’t.

Sometimes Joe — attentive to Simone’s comfort, but not a cat person — got exasperated when she scratched at the door.

“What does she want?” he’d grouse.

Occasionally when her food and water bowls were full and she was scratching at the door he’d open it, bend down, and ask: “What do you want? Eh?” It made me laugh. She wanted company, liked nothing better than sitting between the two of us on the sundeck, and whenever one of us went outside she stopped miaowing. But one day I looked at her reaching a paw up and thought, maybe she doesn’t want anything. Maybe she’s offering help. Animals know when people are in pain. In “Dewey”, a book about a famous library cat, the author tells how every week when a book group convened the cat would go directly to the one member of the group who was depressed, and jump up onto his lap, purring. I was sure Simone knew I needed to become comfort-able again, and that she could help.

After breakfast one morning I pulled out my notebook and jotted a reminder of three pillars of the Life is Now progam.

Need to do three things to heal:

Aware of body

Breathe calm

Re-educate brain

What could I do to facilitate these healing steps?

I took a sip of juice and tapped my ballpoint pen rapidly against the table, until Joe looked up from his book with a frown and I realized what I was doing.

“Sorry.”

In a weird way, this was progress. For a long time, normal sounds — rock music for instance, at a volume I’d usually enjoy — had been getting on my nerves. (What did that actually mean, to “get on the nerves?” No doubt neuroscientists would find out, if they hadn’t already). Now, I could beat a tattoo with a pen without even noticing. Was my nervous system finally calming down?

I jotted a note in my journal: Sound less disturbing?

There I turned my attention back to the three pillars.

For body awareness, I scribbled: FEET.

As a child growing up in New Zealand, I’d gone barefoot. My brother and I even walked to school shoeless. That was normal in the pastoral suburb of Auckland where we lived, and even my teacher came to school barefoot. But when we moved to Canada, and into a 5th-floor apartment in Vancouver’s highrise-heavy West End, my parents enforced the wearing of shoes. I still went barefoot at home, though, until my husband and I moved into my mother’s downstairs suite in her final years, and I got plantar fascitis from the concrete floors.

Ballet made my feet even more sensitive and responsive. My husband was amazed when I said my feet were more sensitive than my hands, but I’d learned the world through my feet, and since I’d started wearing shoes all the time I knew I’d become disconnected in some vital way, ungrounded.

I slid my feet out of my crocs now and stood up. Closing my eyes, I tuned in. Why were my soles tensing so against the hardwood floor? The answer came immediately: FEAR! This was going to hurt! But it didn’t actually hurt to stand here for a moment, did it? How much was the fear of anticipated pain, exacerbating…or even, causing?…plantar fascitis.

And, how much was ANGER at losing that proprioceptive barefoot connection, intensifying the problem?

I stood on the ergonomic mat at the kitchen sink. Pressing the raised rubber bumps with my toes and heels, I enjoyed the gentle massage of fascia tissue, the enlivening proprioception. Slipping into a Life is Now awareness exercise, I checked my breathing: ragged. When I tried to lengthen the inhale, to slow it down, the unpleasant shuddering in my ribs made me stop. I checked in with my body, pressing the mat…oooh, that remembered alignment, as I found the plumb line that ran through ankle, calves, knees, thighs, hips…spine stretching upwards…ahhh, this felt so good! How long since I’d stretched my spine up tall?

What about emotional awareness? What did I feel? Nothing. Just, numb. I realized I was tensing my belly, keeping all emotions tightly held in.

Relax.

As I let my belly go, anger flooded in. Urgh! All this time, wearing shoes, disconnected! What I’d sacrificed, standing on those concrete floors! While my mother had deserved my care and attention, and while I honestly couldn’t have had a better mother, and while I was proud I’d been able to be there for her, giving back a mere fraction of what she’d given me, my inner child was FURIOUS that to live in her house I’d subjected my feet to concrete floors that shouted harshly at my feet all day. Like fascists!

No wonder they called it plantar FASCITIS.

There was a deeper truth too, a worse kind of pain. The agony of seeing a tremendously strong, vital woman forced to slow down and finally bend to illness and death. My brother and I had formed a tight team with her GP, working together to convince her to to take more medicine or go to hospital when she proudly resisted. We’d kept her alive until she was ready to go, and still, I couldn’t let go. Part of the pain of DE FEET?

I vowed to start going barefoot again. I had a gut feeling that I could kick this plantar “fascist” now.

Back to my notebook and the three pillars.

Pressing the ground to connect with my body was going to be very successful.

Now, what about calming my breathing?

There was a powerful breath awareness technique Pearson used: to pay attention to the feeling of the breath entering and exiting the tip of the nostrils. That first touch of breath used to feel calming, and more — mystical and profound in some way. But now, when I tried it, I only got more tense.

But, wait. Only the left side of my body was tense. Ribs, lungs, shoulders, waist.

My left nostril was blocked, somewhere. I wasn’t taking in enough air through my left nostril.

Eh?

In the past, if I made a discovery like this, I’d go running to a doctor and ask to have my nose checked. But my belief system was changing. Since I’d found out that what medical professionals had been telling me for decades — that structural issues were solely responsible for my pain — wasn’t true, I wasn’t inclined to go to my GP except in an emergency. I was done seeking medical attention every time I found something not quite right in my body. I’d just keep watching and see what I discovered.

That took care of item Number 2: feel breath at tip of nostrils.

I took another sip of juice. How to attack the third pillar: Re-educate brain?

The videos in the online self-management program about how the brain creates pain, and how it can stop it, would serve. Plus, I’d keep sending mental cues to my nervous system to calm down. “That’s an old story. You just got over-excited. Let go.”

Joe’s ipod was playing quietly, and as the Doors song “Break on Through” came on he started singing along: “Break on through to the other side, break on through…oh yeaaaaaah.”

I took off my Crocs and joined him, singing and gently dancing around the kitchen. Dancing! This was a bold, brave step, challenging the intense fear that moving would cause another spasm. As my feet pressed the floor, the pain — focused in my left hip at that moment — receded, and a wave of heat and energy flowed down my leg into my foot. What had just happened?

Still exhilirated thinking about this moment later, I scribbled in my journal: “Grounding!”

Something was happening. I didn’t know what it was, but moments like these convinced me to keep sticking to my healing program, no matter what.

Pearson vs. Sarno; Changing pain with emotion; New partner on the road

I stood in my bedroom with my back to the full-length mirror. Tugging my T-shirt out, I eyed the bump in my spine, just below my waist.

For more than 30 years, medical professionals had been telling me that this bulge — combined with a scoliosis and deteriorating discs — were the reason for my pain.

Only now I’d discovered I could change pain with a THOUGHT.

I tucked my T-shirt back in.

It was time for a reality check.

I decided to review what I knew about these structural defects in my back and see if I now believed they had any relation to pain whatsoever.

I first noticed the bulging vertebra in Grade Six. It was 1967, and Canada was on a government-mandated fitness program. Children practised sit-ups, chin-ups, and other exercises for weeks to earn sew-on bronze, silver or gold Centennial Athlete fitness patches.

We took to the bare wooden Gym floor in pairs. I held my partner’s feet down as she executed her first 10 crunches, grunting and groaning. When my turn came, and I tried to sit up, it wasn’t just my stomach that hurt.

“Ouch!”

Something in my lower back was pressing into the floor. Feeling around back there, I found this lump. I felt ashamed, deformed, ugly, and as far as I can recall, I kept it to myself.

Then, a decade later, I saw a physiotherapist for pain in my upper back, and she ordered X-Rays.

“Spondylolisthesis at L4-5,” she crowed triumphantly, stabbing her finger at the scan report.

Oh. That unsightly bump had a name?

She frowned.

“How can you possibly dance, with your back?”

Her response scared me. Could this long-worded vertebral bulge potentially stop me from dancing? Dance was everthing to me.

“Dancing is not just physical, you know,” I shot back. “It’s art!”

“A piece of your vertebrae is missing,” she explained. “Probably, since birth. That makes your back unstable.”

Yikes. If my back was unstable in my early 20s, what would happen to it as I got older?

What happened was that the pain increased, and scans revealed increasingly alarming findings. My GP sent me to physiotherapists, massage therapists and back clinics, and by 2008, the news looked really grim. I had “moderately severe” narrowing of multiple disc spaces, with associated osteophytes “resulting in bilateral encroachment of variable severity involving the 3-4, 4-5, 5-6 and 6-7 neural foramina.”

The conclusion?

“Degenerative disc disease at multiple levels.”

All the medical experts eyed the scans and shook their heads in sympathy.

“No wonder you hurt,” they’d say.

My GP referred me to the Pain Clinic at St. Paul’s Hospital, where I saw an OT, PT and a pain doctor. Meanwhile, I dropped one well-loved physical activity after another: dance, swimming, yoga, finally, even walking for more than 5 to 10 minutes, because it hurt too much.

Finally I found the work of Neil Pearson, and for the first time became able to self-manage the upper back pain that had dogged me for decades.

Now, 4 years later, I was just starting to experiment with Pearson’s online program, for a new problem: severe lower back spasms.

A moment ago, I had made the pain the drop suddenly and radically, shifting it 4 points from a 6 to a 2 on the pain scale. By changing a THOUGHT.

This was new. I had never made pain drop so much in an instant.

For f—‘s sake! If I could change pain with THOUGHT, the problem was in my BRAIN, not in my BODY! Was all that so-called medical expertise from doctors and other medical professionals I’d seen over the years no better than witch doctorery?

Not that I’d discount a witch doctor, at this point. If pain could be changed with thought, maybe a witch doctor could scare it away.

Uuuuurgh! Furious at the wasted hours, days, months, years, the DECADES of struggling with pain, I let myself go for once, kicking and beating the air with my fists, cursing all the while. When I stopped my whole body was tingling and the pain was gone.

Amazing!

Why didn’t I ever let go like that?

It was time to investigate anger.

Hobbling into the kitchen, I thought about my conflicted relationship with anger. For most of my life I’d had a problem both feeling it and expressing it. Even as a child, watching another girl have a temper tantrum in a store, pounding the ground with her fists, I felt embarrassed for her.

And yet, part of me longed to be able to let go like that, to be so wild and out of control.

In 2012, I’d used an awareness technique of Pearson’s, alternating attention between my body, breathing, thoughts and emotions, and made a startling discovery. When I tuned in to my emotions, I found that I was angry a lot of the time.

Pearson sounded surprised, too, when I told him of my discovery.

“Really?” he asked, curious.

No wonder. People always said that I seemed very calm. Clearly my feelings did not concur with my appearance because I rarely felt calm. My emotions were easily aroused…the ones I could feel, anyway: joy, sadness, excitement, frustration, and impatience. But not, I admitted to myself, reaching up to the shelf where we kept the tea and coffee, anger.

Hmmn.

I needed a cappucino, or at least the semblance of one, a decaf, the closest I dared come to caffeine these days with thoughts racing and heart pounding all the time.

I remembered back to that time, how I’d wondered, where was all this anger coming from? I’d decided it must be a result of being in pain all the time. Who wouldn’t be furious if they were in constant pain? I’d stopped the awareness exercise, stopped paying attention to my feelings.

Maybe I hadn’t gone deeply enough into it. Maybe Dr. Sarno was right.

I went to the bookcase, pulled out John Sarno’s book and began to read it again as I made my way back to the kitchen.

It was shortly before seeing Pearson, 4 years ago, that I’d discovered this slim paperback, “Healing Back Pain”, and read Sarno’s theory about a connection between repressed anger, and pain that persists. His theory had seemed simplistic to me, but his case studies were convincing, and a lot of what he said had resonated.

Like Pearson, Sarno had become frustrated by the inability of the medical system to provide anything but temporary relief to patients. As medical director of outpatient services at the Rusk Institute of Rehabilitation Medicine at New York University, he saw many people with chronic neck, shoulder, back and buttock pain. Virtually all presented with tender areas in the back, the back of the neck, and in the buttocks: the postural muscles.

No doctor had checked me over to ascertain if I had tenderness in these areas. But I knew where I hurt. The pain moved around, but it was always in these areas.

Hmmn.

I put the book down and took a bag of decaf beans out of the cupboard. At age 30 I’d put myself through two years of acting school, followed by months of expensive therapy, to get in touch with the emotion I repressed. I didn’t know at the time that that’s what I was doing, but I’d since come to know it, at a gut level. Anger was a potent life force I’d stifled, and I still had a hard time accessing it.

But could it really cause persistent physical pain?

Sarno profiled one patient, disabled by terrible back pain, who — due to cultural dictates — had never been allowed to go to school and could not read or write. She’d buried her resentment about these restrictions, and stifled the rage she found unacceptable. Sarno’s educational program, augmented by psychotherapy, had cured her.

This was just one of many examples.

Was repressing rage the basis of my pain? Did I have the condition Sarno called “Tension Myositis Syndrome”, or “TMS”, for short?

I decided to do a quick and dirty self-diagnosis, giving myself one checkmark for each symptom that fit the TMS profile.

Stuffing your anger?

Checkmark numero uno.

Tenderness in all the areas Sarno listed?

That was two ticks.

But…

Sarno’s theory was Freudian, and I was skeptical of Freud. The cocaine addict who didn’t understand women had become something of a laughing stock. Penis envy? C’mon.

I poured some beans into the grinder.

On the other hand, Freud’s theories had changed psychology forever. Concepts like denial, projection, and rationalization were now key to our understanding of how human beings function. Therefore Freud deserved considerable respect.

Spooning ground coffee into our stovetop espresso pot, I mentally reviewed Sarno’s hypothesis: persistent pain was a strategy the brain created to divert people’s attention from what was bothering them emotionally. When emotions like rage, originating in the subconscious, threatened to break through to the conscious mind, the brain created mild oxygen deprivation in certain areas of the body. Not enough to cause actual physical damage, but enough to cause some really nasty pain.

Hmn. Mild oxygen deprivation, as a distraction technique? I could buy that. But Sarno had no proof. All he had was a theory

I screwed on the top of the espresso pot and set it on a burner.

And yet. And yet.

When Sarno began explaining the concept to his patients, he found to his astonishment that this “educational” talk alone — combined with an assurance that they didn’t need to be able to stop repressing emotions, only to accept what was happening and talk back to their brains — could sometimes be all that was needed to effect a complete cure.

I took the milk out of the fridge, poured half a cup and nuked it.

Pearson, too, had shown that education about how pain works was a vital component in recovery. On a personal level, his educational talks had certainly helped me.

The self-talk he advocated had also helped.

However.

These two healers diverged in key areas. Sarno told TMS sufferers that when the pain came on, they must immediately switch their attention from pain to their thoughts, and find out what was bothering them emotionally. I’d tried this, with a small measure of success, but I didn’t like the feeling of distancing myself from my body. Pearson’s “body scans” had taught me to do the very opposite, to pay attention to my body, and by doing so I’d become aware of physical tensions and learned to let some of them go.

I whipped the hot milk and reviewed:

I had pain in the areas Sarno indicated.

I repressed anger.

And, a scant hour ago, I’d found complete relief from pain when I released anger.

The pain had crept back by now, but what had happened when I was cursing, punching, and kicking the air? How exactly did that work?

The coffee began to bubble. I poured it over the milk and took cup and book into the living room. Setting them on the coffee table, I stretched out on the couch, draping myself around a body pillow. Ahhh. Side-lying, the only position of comfort I’d found, brought such relief, and how good it felt to allow myself this rest.

I closed my eyes and continued my train of thought.

Sarno had compared his patients’ medical histories, and found that 88% had suffered disorders traditionally linked to tension and stress, such as headaches, asthma, skin conditions like eczema, heartburn, and stomach and bowel problems,.

Heartburn.

Yep.

TMS checkmark number 3.

It was 20 years since the attack of heartburn that led my GP to put me on meds for acid reflux. The day of the attack was burned into my mind — and, into my gut, it seemed.

My boss — a big broad-shouldered,intimidating woman — called an unpaid after-hours staff meeting. We squeezed into a small room she designated with not a little trepidation, and she stood in the narrow doorway, spewing the “f” word venomously.

We were too concerned about our jobs to protest, and not one of us dared to meet her eyes. But inside I was raging, and when I looked up and saw tears rolling down a co-worker’s cheeks, I was furious with myself, too, for being such a coward.

That night, my husband and I dined at an East Indian restaurant. Walking home afterwards, I felt an uncomfortable pressure in my chest and stomach acid regurgitating into my throat. I assumed it was the curry, although we often ate curries and I’d never had heartburn before. But when I told my GP about the boss going ballistic and yelling, she didn’t blame spicy food.

“I see this type of thing all the time,” she sighed, shaking her head, and reached for her prescription pad.

I later found out that I was far from the only staff member popping Omeprazole twice a day to stop naseau and burning in my esophagus.

My doctor had never attributed physical symptoms to psychological causes before. In fact, she’d chided me on several occasions for doing just that. And yet here she was, basically admitting that repressed rage caused heartburn.

I relived a bit of that day just thinking about it. Relax, I told my gut, feeling the stomach acid rise. That was then, this is now.

If stuffing your anger could cause acid reflux, what else could it do? Could it cause persistent pain?

Why not?

I was no doctor, I didn’t know what was taught in medical schools. But psychosomatic pain, or “somataform disorder”, or whatever doctors called it nowadays, was a recognized disorder. Just because I didn’t fit the profile didn’t mean I didn’t have it.

Should I stop following Pearson’s program and only follow Sarno’s advice?

But, Pearson’s online program was already bringing me some measure of relief, and it was supposed to take 4 to 6 weeks to really show results. Plus, his work had relieved so much pain in the past. It had given me my life back.

Not only that. His awareness exercises had led to spiritual revelations that penetrated to the very core of my being. Not everyone reacted to the work that way, but it had happened to me, and rejecting the online program he’d built, that I’d started two weeks ago, would deprive me of more pathways to connectedness, the thing that now gave my life meaning. Why reject such a profound gift?

I could feel every part of my body tense as I contemplated this dilemna. My arms and legs were gripping the body pillow, my jaw clenched and my tongue tightened. Sarno, or Pearson?

Then I realized I was pressuring myself uneccessarily, a lifelong habit. I didn’t have to make a decision now. I could take my time. I hadn’t even completed my quick-and-dirty self-diagnosis for TMS.

Ahhh. How good it felt to relax, to let some tension go.

I returned to thinking. What about those other medical problems Sarno’s patients had in common?

Stomach pain?

Uh huh.

TMS checkmark number 4.

The acute pain came on suddenly, in my mid–40s. My GP ordered tests, which revealed nothing out of the ordinary, and finally she labelled it IBS, a name physicians slap on undiagnosable stomach and bowel pain.

I was doing a Masters in Creative Writing at the University of British Columbia at the time. Although I had a fellowship, I remained on call at my stressful job. The boss made it clear it was either that, or leave altogether.

Competition to get into the Masters program had been stiff. I’d become a grade junkie. Furthermore, I was determined to win a fellowship because I couldn’t deal with the thought of a huge student loan hanging over my head. I broke down in a professor’s office after she gave me an “A” on an assignment. An “A” wasn’t good enough. Only students with an A-plus average would be considered fellowship material.

UBC accepted me into the Masters program, and the day I found out I’d also been awarded a full fellowship I almost screamed with joy. The first term went smoothly, but on my way to the last Fiction class of the second term, wrenching stomach cramps knocked me to the bathroom floor. Soon I had them every time I ate. I lost 10 pounds because I was afraid of food. When all the tests came out negative and elimination diets revealed no food sensitivities, I couldn’t help wondering: was this a “gut reaction” to the extreme pressure I imposed on myself?

“Are you working too hard?” one professor asked.

“I don’t know,” I confessed.

How did people gauge stress? Nothing had ever equalled the extreme physical, mental and emotional challenges of classical ballet, and I didn’t know how to compare the pressure of the Masters program to that. Sure, I was tense, set impossible goals for myself, and an inner critic bullied me incessantly, but wasn’t that par for the course, for creative people? As choreographer Martha Graham once noted, there is no satisfaction for artists, “only a queer divine dissatisfaction.”

Besides, all we were doing was sitting in chairs all day.

Plus, I was living my dream. I didn’t deserve to feel stressed.

My eyes snapped open and I sat up.

Didn’t DESERVE to feel stressed?

I took a sip of cappucino and felt myself getting very tense again. I let my gaze drift, looking out the window. Outside, puffs of cloud were wafting across a blue sky. Luxuriating in the ease of doing nothing for a moment, I snuggled down into the sun-warmed cushions. Ahhhh.

Then my mind rebelled and my body tensed again. I should be achieving my potential, not lying about wallowing in my own misery!

The only other classmate to receive a full fellowship had signed a 2-book deal while she was still at UBC. She was a well-respected author now. She’d made a success of herself. All I had to show were a few published essays and short stories.

Envy rose, bile in my throat. I pushed it down. I didn’t want to be that jealous, whiny creature. I didn’t want to lower myself to that level.

One thing was clear: UBC had wasted a perfectly good fellowship on me. The familiar dark cloud of guilt descended. Many of my peers had produced work of such a high calibre, and had achieved such great success, that I couldn’t understand why I’d been awarded a fellowship and not any one of them.

Perhaps they weren’t grade junkies. Perhaps they hadn’t paid the price my fellowship sister and I had, for the pressure we put on ourselves to achieve an A+ status. Because during the program, she’d confessed that she had alopecia.

Her hair was falling out. And I couldn’t digest food.

But.

I didn’t hear reports of her lying around crippled by pain. She’d obviously found a way to handle extreme pressure.

I took another sip of cappucino, opened Sarno’s book, and reviewed the personality profile. His patients were perfectionists who pressured themselves to achieve, and had low self-esteem.

My fellowship sister had two out of three of those character traits. But, low self-esteem?

I took another sip and thought about the differences in our personalities. Once, she’d told me she couldn’t wait to stand up in front of an audience and read her work. She felt she deserved an audience. Of course she did! Her work was outstanding, and she’d become an internationally respected author.

She believed in herself.

Whereas, my belief in myself wavered all the time. I didn’t even feel I deserved to feel stressed. And I had no desire to stand in front of an audience ever again.

The fact was that even as a dancer I’d never wanted to perform, but had been pressured into it in my teens by my ballet teacher, then by my peers, and finally it had just become part and parcel of what I did. I loved being onstage when I could conquer fear, let my ego go and just surrender to the moment. But that didn’t always happen, and when I felt like I was just “faking it to make it”, shame would later swamp me. I’d lie awake all night before performances fretting about what could go wrong. It was all so harrowing that I’d finally stopped performing because I was too disappointed at my imperfections and just didn’t want the stress any more.

At UBC I’d soothed myself with the delusion that screenwriting, my chosen main genre, would allow me to hide in a room tapping away on a keyboard and never have to face an audience again.

Ha! That had not turned out to be true.

I took another drink of cappucino.

Low self-esteem.

Was that my problem?

My fellowship sister didn’t have low self-esteem. She never blew her own horn, in fact, she was so quiet in class, she rarely ever said a word. But all the time she’d been driven by a fierce inner fire, a burning desire to be heard.

My fire flickered. One moment I’d look at my writing and think, this is really good! The next day it all looked like dogshit.

But, low self-esteem? Really? I thought of myself as quite a confident person overall, despite my insecurities. Socially, I was highly competent. In that arena, I soared. It was mostly as an artist that my self-esteem failed.

I did a quick review.

I hurt in all the same areas as Sarno’s patients.

I’d had at least two of the medical problems common to his patients.

I shared all their personality characteristics.

My husband came up the stairs. Lunch time. Thank God. This intense self-analysis was exhausting.

After tuna salad, an apple, and a nap, I Googled “Dr. Sarno” and found a website some of his patients had created, titled: “Thank you, Dr. Sarno”. I read at a few testimonials, and found them quite convincing. These stories gave me hope, and the doctor’s humble, nerdy style also appealed. His books were modestly priced. This was no con artist out to make a buck or a name for himself. Like Pearson, he appeared to be acting purely out of care and concern for people in pain.

Pearson’s elevator mechanic came to mind. That guy had almost died when the elevator he was working on fell six stories. Pearson’s team got him back on his feet, and he went back to work, and was doing really well until he got a call for a repair job in the building where he’d been injured.

He walked in the front door, and the pain began.

He walked out again and it stopped.

He repeated this experiment several times, and then he called Pearson’s team, laughing. Until that moment, he could not believe that, as he put it, “an inanimate object could cause me pain.”

Of course, it wasn’t the elevator, but his brain causing the pain. The brain made up a story, based on previous experience, and sent “danger” signals to stop him reaching that one particular elevator. Because it believed that elevator would kill him. Because it almost had, before.

Only, the story was WRONG.

If the brain could make up a story about imagined danger, and get it wrong, and use pain as a protection mechanism, could it also create persistent pain as a strategy to keep EMOTIONAL pain at bay?

And, could it get that story wrong, too?

Because, who wouldn’t rather feel emotional pain than physical pain that ruined their lives? Bring it on!

I got up from the computer and tried to summon anger. But I couldn’t. When I tried to get angry, all I felt was a familiar numbness.

The next day, I continued to Google “Dr. John Sarno” and found a website called the TMS Wiki. Here were more success stories of patients who’d cured themselves using Sarno’s methods. A few had taken the “book cure”; they read his book and the pain stopped.

I wasn’t one of those. I’d read the book several times. I still had pain. But their stories gave me hope.

These people had found individual paths. They’d used Sarno’s theories but had employed other methods too, incorporating bodywork into their recovery strategy, partnering with physiotherapists, massage therapists and other medical professionals.

Pearson also advocated a holistic approach.

I decided I would continue to use Pearson’s online “Life is Now” program. But I’d also experiment with Sarno’s techniques, using the TMS Wiki site as a resource.

Would one methodology adversely affect the other?

I certainly hoped not.

The people-pleasing part of me felt guilty about my plan. The benefits I’d received from Pearson’s work had given me profound respect for the man. Would he be angry if he knew I was using Sarno’s techniques, too?

Luckily I recognized this as complete bullshit. Talk about low self-esteem! It was my LIFE I was talking about here. No doubt Pearson would be happy if I got well, no matter what methods I used. But — and this was far more important — what did it matter how the man I called my “pain guru” reacted?

I thought of myself as a strong person, but clearly I had some issues with people-pleasing to examine.

Hmn.

Just like Sarno’s patients.

One of the key aspects of Pearson’s online self-management program was goal-setting, in tandem with a health care professional.

It was time to find someone I could work with, locally. Which health care provider should I reach out to? Who would help me set goals, and review my progress from time to time? My current GP was always so busy. I couldn’t imagine him seeing me on a regular basis just to check in about goals.

Besides, he was old school. When I explained the self-management program he nodded approvingly, but when I handed him a 12-page printout that the program supplied for clinicians — “Overcome Pain: An Optimistic Scientific Model” — he just slipped it in my file without even glancing at it.

I couldn’t blame him. When would a busy doctor find time to read a 12-page printout? But I needed someone to help me, someone open to the new paradigm of mindbody medicine for “chronic” pain.

Local physiotherapist Mieke Truijen seemed the obvious choice. She’d actually studied with Pearson, and she had Butler and Moseley’s “Explain Pain” book, that Pearson had reccommended, in her waiting room. She was into this stuff. To top it all off, her clinic was only a 3-minute drive away from our house.

Mieke would also understand when I said I was learning to lower pain with my thoughts. And, by releasing emotion. She’d believe me.

But there was a problem.

I’d seen Mieke for various aches and pains over time, and she’d always helped me. So, when the first low-back spasm struck in the fall of 2015 I’d naturally gone to her for help. But the spasms kept returning and I became discouraged.

Also I had increasing sensitivity to clothing, and had taken exception to a comment she’d made. I mentioned that I was having trouble tolerating even the seams of pants, pressing against my thighs.

“If you don’t do something about that, soon you won’t be able to wear anything at all.”

She wasn’t being judgmental. She was just a plain speaker. In fact, I would often replay that sentence in my head and eventually it would help push me to find a way to stop the pain. I actually needed her to say it, to voice my worst fears, bring them out into the light. But at the time, the attempts I was making at desensitization, based on standard medical practise — brushing areas gently with different textures of cloth, such as silk, cotton, and gauze — simply made the hot prickly pain increase, and I didn’t know what else to do. Instead of confessing my despair, I bristled inwardly and stopped seeing her.

Now I had to overcome my reluctance and ask for her help. It was time to eat humble pie.

“Come in, Barbara.”

Mieke’s Dutch accent made my name into “Bah-barra”. I enjoyed her accent, and her energy. Vigour seemed to shoot out of every part of her, even the brown hair that glinted auburn in sunlight and the mischevious green-flecked hazel eyes. Her stamina was amazing. She taught fitness classes as well as practising physiotherapy, and would even see clients on Sundays.

Once, at the end of an evening appointment, I asked her:

“How many people have you seen today?”

“Oh, Barbara,” she replied, “I can’t think like that.”

This comment helped me think differently. Here was someone who didn’t anxiously count the hours ticking by and tense at the thought of a heavy work load. Living in an imaginary future wasted energy, and as the months went on, when I caught myself projecting into the future, tensing and worrying about what was to come, I’d remind myself to be like Mieke and relax into the moment. This would help my pain to lessen.

“So, what’s going on?” Mieke asked.

I told her about my year of Hell. The back spasms that wouldn’t let up. The ragged breathing. How every day, when I woke up, my calves felt like I’d been climbing mountains all night, and how they looked like, it too. How, when I hauled my sore body out of bed every morning and saw myself in the mirror I was amazed at how “in shape” I looked, even though I could barely exercise at all.

“My thoughts are racing all the time,” I confessed. “There’s this odd feeling of detachment from my body, as if it it doesn’t even belong to me.

And my heart is pounding all the time, even lying in bed.”

“If you’re having any trouble with your heart, you have to tell your doctor,” she warned.

I nodded.

“Is this what happens when you turn 60? Suddenly your body gets all stiff and your muscles lose their elasticity?”

She nodded at the padded table. Carefully I climbed up and she began to gently manipulate my limbs and massage my back. It felt good, so why were tears leaking out of my eyes, seeping into the cushion she’d placed under my head?

“Why are you crying?” she asked gently.

“It’s just…I’m…”. I didn’t know. Maybe it was pride, giving myself over to someone else for help, when I’d been trying so hard to solve my own pain. Then there was fear at being touched when my back was in spasm. And finally there was the humbling aspect of this return to a practitioner who had helped me so much in the past, and whom I’d rejected a year ago on the basis of one well-meant comment.

Mieke just let me cry. I could feel empathy without any cloying overlay. I didn’t need or want a hug, I just wanted to let go and for that to be okay. Her silent acceptance as she continued to work on me told me that it was.

Goal-setting could wait for our next appointment.

Next time I saw Mieke, I told her I wanted to set similar goals to the ones that had helped me conquer upper back pain, in 2012. Walk for five minutes, add a minute each day.

“Just don’t do too much too soon. I know you, Barbara. Don’t go all crazy and overdo it. Just walk. And swing your arms gently.” She demonstrated. “You have to bank your energy.”

I stared at her. This was a new thought. Conserve energy? Not go all out?

Pearson said it was important to find a baseline, to exercise just to the edge of pain, not push past the place where you could keep your breathing and mind and body calm. The unpredictable nature of my pain made it hard to find a baseline, and I’d stopped trying. I told Mieke.

“Don’t worry about that,” she reassured me.

When I took a brief stroll to the lake the next morning, I was tempted to push it, but remembering what Mieke had said I resolved to stick to 5 minutes even though I wanted to try for 6. Knowing I was going to stop before I hurt made me feel wealthy, rich in energy instead of frustrated at my limitations. A luxurious feeling of relaxation settled over me. I felt in control and well cared for.

In September, 2016, everything began to change in my life. Not that I was doing much. Outwardly. I’d stopped paying attention to what was going on in the world.

On September 1st, a South Korean palm oil company was accused of setting vast tracts of tropical forests aflame in Indonesia. On September 2nd, Samsung Electronics issued a recall of Galaxy Note 7 smartphones with fire-prone batteries. And on September 3rd, the President of the Phillipines, Rodrigo Duterte, declared a nationwide “state of lawlessness” following a bombing in Davao City that killed at least 14 people. I was ignorant of all of this, locked in a battle with crippling pain that demanded all my attention. I was becoming a shut-in, rattling around the house in a terrycloth bathrobe.

But inwardly I began to experience the most profound changes. My belief systems, self-image, remembrance of the past and vision of the future, all of it came up for question. The revelations astonished and bewildered me, freed me and tied me in knots, and I will always look back on that time in wonder and amazement.

At midday on Saturday, September 4th, 2016, I lay on the living room floor, unable to move. It was my birthday and we were seating 12 for lunch. What an assinine idea, to host my own 60th birthday bash with crippling lower back pain!

I knew I needed to challenge the pain. Under Neil Pearson’s care in 2012, I’d virtually recovered from decades-old “chronic” upper back pain, with a recovery plan that included gradual physical challenges. My upper back gave me little trouble these days, but in the fall of 2015 my lower back started going “out”, and repeat episodes had severely restricted my life. I was fighting back now, and challenge was part of the strategy.

Pearson is far from the first specialist to incorporate physical challenge into recovery programs for people in pain, of course. Rehabilitation medicine has been around forever. Only, people with so-called “chronic” pain, like me, had been told there was no help for them besides medication or temporary relief from massage, hot packs or similar aids. That paradigm, however, was beginning to change.

Lying there on the floor I cursed inwardly. I thought I’d paced myself well. Exercises in the online self-management program — body scans, breath awareness and gentle movement practises — had kept me afloat while I dusted, made beds and baked granola, preparing for an influx of house guests. Obviously I’d overdone it.

Most of the guests were sitting around the dining room table chatting softly while we waited for the last two to arrive. I was grateful no-one hovered, that they gave me space while I considered options. Take another Baclofen? I took 10 mg of Baclofen and 75 mg of Lyrica daily for pain. I’m a cheap stone and while another 5 mg of Baclofen might not touch most people, I could be high or falling asleep in my soup.

Besides, pain killers didn’t always work.

This party was a gamble. As a shut-in who avoided people, absorbed in the battle with pain, I sorely missed the love and laughter that flowed when family and friends were around. But Pearson and pain scientists like Lorimer Moseley stressed that socializing can release feel-good chemicals our bodies naturally produce. Love could open this “medicine cabinet”. I was about to experience that for a fact.

“The pain must be bad, eh?” my brother asked with concern as he arrived. I could only nod.

“We brought the quilt,” he said, holding up a big plastic bag.

“Oh! The quilt!”

Before I realized what I was doing I’d rolled onto one side and stood up. A moment before I’d been in too much pain and fear to move. I put it down to adrenaline. I was so excited I was shaking, and I couldn’t wait to see this extraordinary gift from a woman I didn’t know very well.

The quilt was a present from Veena, a graceful, petite East Indian-born woman who’d belonged to my mother’s Friday night dinner-and-a-movie widows club. I’d coverted a gorgeous bedspread she’d made out of old saris. In spring I emailed, asking if she’d accept a commission. I’d pay well for such practical beauty.

“Alas,” she replied, “I have long given up quilting. Body stopped cooperating with my hobbies.”

I’d heard nothing more from her. Then, on August 30th, a totally unexpected email from Veena appeared in my inbox.

“It’s ready”, the subject line stated.

I felt my mouth form an involuntary “oh!” and my hands come together automatically as if to pray. As a former dancer I observed my body from a distance, curious, not having been raised in a religious tradition that included prayer. I reached for the mouse and clicked.

I’d met Veena at the Friday night club in my mother’s final years, when I started joining the widows so I could offer Mum my arm to hold. She’d started falling down but refused to use a walker. She groused to her friends about the bossy “Mum police” (as I titled myself, to both acknowlege the dire truth and give us a laugh), but she didn’t want to end up in Emerg again with a split lip and bruised knees.

Mum’s spirited friends often talked politics at dinner after dissecting the film. While I enjoyed their conversation, I also appreciated Veena’s calm and quiet presence. It soothed me, and I admired the gentle humility that augmented her sari-clad beauty. One night we discovered a mutual interest in meditation, to the consternation of most of the others, all but one of whom were suspicious of such esoteric practises. After that we’d just catch each others’ eye sometimes and exchange a secret smile.

This was the extent of our accquaintance, to date.

Until this email at the end of August.

“Ever since your interest, two saris volunteered,” Veena wrote, “so I started on this venture. It was slow going, but it is ready now.” She’d sent two photos. The quilt was a generous 7 x 8 feet. It looked light as air. My pain flared when I threw heavy blankets off in the middle of the night, but I’d be able to toss this coverlet to one side without feeling a thing.

Veena had sewn six panels together. On one side, a generous expanse of royal blue silk surrounded an intricate central mandala in white, navy, pale blue and peach tones. On the other side the multi-coloured theme prevailed.

What serious physical challenges had a woman in her late seventies overcome to produce this exquisite creation? How many hours had she laboured over it? If she’d started in early May, it had taken nearly four months.

When I phoned to express my gratitude, ask the price, and inquire gently as to what physical restrictions she’d overcome, and how, she said she had bad arthritis in her hands, but making the bedspread had been such a joy that now she was thinking of making another one, to give to another friend. She refused to accept payment. “Think of this as a paying forward gift,” she said.

I’d invited Veena for the birthday weekend, but she didn’t like to travel any move, so my brother’s partner had arranged to pick up the quilt and bring it. When Bobby pulled it out of the bag we all oohed and ahhed. The silk was covered in a running-stitch motif of stars and swirls, and the thin fabric shone in the sunlight as one of my sister-in-laws fingered it with reverence.

“This is handsewn, you know.”

“It is?” A non-sewer, I gaped at her stupidly.

“Every stitch.”

I looked at it more closely. Of course it was. I’d just assumed that Veena would have used a sewing machine. I was even more stunned at her accomplishment now. Wrapping it around my body, I felt love roll all over me.

I’ve been blessed with a lot of love in my lifetime. I have the deep close love of my husband, the affection of family and friends, and the appreciation of students. Once, the mother of a ballet pupil brought me a silver-plated cake lifter. I’d only been teaching her daughter a few months, once a week, but she pressed it insistently into my hands. “So beautiful, the dancing!” she exclaimed in stumbling English. “So much grace.”

Sometimes love came from strangers, in the form of applause at curtain calls, or smiles like that of a woman on the street outside Vancouver General Hospital whose radiant expression warmed my heart for a whole morning as I sat by my mother’s bed in Intensive Care. Veena’s love was like that. There was nothing personal about it. It wasn’t about me. This was a selfless compassion.

I hadn’t told Veena that I was in constant pain and weathering one of the blackest periods of my life. Nor had I told her that at first I’d wanted a pink quilt. I wanted to be “in the pink”; but lately blue and white hues had begun showing up in my meditations.

It wasn’t until I sat down at the table that I realized that my pain was gone. Had I taken another pill? I couldn’t remember. Pain played havoc with my short term memory at time. Could I have opened the drawer where they were kept and swallowed one absentmindedly in my excitement? Not likely. But even if I had, Baclofen had never done this to me before, not even a double dose. I felt absolutely transported.

“You all know I have a bad habit of making maudlin speeches,” I said, rising to my feet and raising a glass of wine. “Well, it’s my birthday, and I’m going to take full advantage of that!”

We toasted each guest. I saved the last toast for my brother, saluting the heart and courage of a man who as a child had been almost phobic about blood and needles, but had chosen medicine as a profession.

As the weekend progressed, each guest found a private moment to say that there was a really special feeling in our house, and how good it felt. I knew that feeling was love: theirs, ours, and Veena’s.

Love and challenge saw me through the weekend. But as it drew to a close, my lower back was so tight and sore I didn’t dare walk downstairs to wave goodbye from the gate, our proud tradition. Something broke inside, and I pasted a fake smile on my face as we all hugged, but there was a taste like ashes in my mouth and in the quiet house afterwards I fell into Joe’s arms, sobbing.

I had to get out of the pain prison.

Notebooks from that time document what happened next. On Sunday September 11th I wrote: “Make plan for day. Respite, Calm, Challenge.” (These three pillars anchor the Life is Now program: respite or “escape” breaks during the day; exercises to calm mind, body, and breathing; and physical challenges.) I didn’t make a plan, however. My thoughts were racing now from the moment I got up, and I couldn’t focus. Besides, writing down plans required sitting. Instead, like a bird I’d just perch on a chair for brief moments during the day and note what was happening as I tuned in to my body, thoughts, and emotions.

This was progress. The pain would not just magically recede, it took a lot of focus, but to watch it change and grow gradually dimmer when I tuned in was huge. This progress was not a straight line, however, but an on-again, off-again thing.

One morning, as I struggled to finish a “to-do” list after breakfast, distracted by brain fog and a sharp ache in my lower back, the pain started moving around. It jumped to my right shoulder; then the left side of my back and hip began to shout mercilessly. What fresh Hell was this?

Giving up on the list I threw down the pen and stepped outside. The beauty of our 300-year-old Arbutus tree, the Douglas-Firs, cedars and maples that border our property, and the dahlias in bloom in the garden below were all wasted on me. Pacing up and down, I decided to try talking back to the pain.

In his book “Understand Pain, Live Well Again”, Pearson had borrowed a suggestion from pain researchers Butler and Moseley: asking yourself, “Is this really dangerous?” when pain flared up. This had never worked for me. I couldn’t get past the idea that any movement might be dangerous, if it hurt. How did I know what was dangerous or not?

This sort of thinking wasn’t logical. There were all kinds of things I avoided every day because I knew they caused damage. Who would put a hand on a hot burner on the stove, for example?

But some things that were supposedly dangerous, weren’t. Like when I was 11 and a ballet teacher had done a visualization exercise that made me relax so deeply my tight hip joints completely let go, and my legs to fall into what had always been an “impossible” position for me. Under normal circumstances to get my legs into this position would have required great force and I’d surely have damaged something. So, how did I know what was dangerous?

On the other hand, the way the pain was flitting about made no sense at all. That’s right, it’s nonsense! I told myself. I felt less inclined than ever to take it seriously. I was ready to experiment.

I decided to imagine that the pain was a child who kept interrupting a conversation I was having with another adult. The child wanted more attention, but I’d given her plenty of attention already.

“Not now,” I said silently, calmly but firmly.

The pain screamed.

I sighed. And then I felt a certain strength invade my core. I felt the “child” beside me, outside of me, small and insistent.

“Later,” I continued calmly, “you’ll realize you just got overexcited.”

I felt distanced from the pain then, above it. The image of one of my sisters-in-law came to mind, and the sound of her serene, intelligent, compassionate voice. I felt as if I was in her body just then; not that I could possibly know what that felt like. And yet I felt I looked like her in this moment: chest lifted, heart open, spine aligned, hips strong above grounded feet.

My sister-in-law spends a lot of time in her garden. She grows organic fruit and vegetables and mindfully prepares food for her family’s table with this luscious produce. Her earthy grounded nature is attractive and reassuring, a balm to my excitable and tempestuous temperament, and as I stood there on the deck, picturing her and talking to my pain, it instantly dropped from about a 6 –on a pain scale of 1 to 10 — to a 2. It was still there, but in comparison to a second ago, a mere dull blip on the radar.

I couldn’t believe what had just happened. I had greatly reduced my pain.

With a THOUGHT.

A shiver of excitement rippled my spine. I had changed the neural pathways in my brain, and changed the pain.

I knew in that moment that the theories were true. I could teach my brain to unlearn the pain. All I had to do was find the right words.

I was so excited, I wanted to tell everyone I knew. As Joe came up the stairs to make himself a cappucino in the kitchen I blurted it out to him. Then I phoned a few family members, getting all worked up, my body tensing with excitement. I couldn’t afford to get worked up. It hurt. I needed to calm down, and I used relaxation exercises and a hot bath to help.

The next day — September 12th — I wrote: “change the story. The story is wrong. Faulty wiring — firemen show up.”

In his videos about the science of pain, Pearson explains that pain is a protective mechanism, and when it persists, you have to change the story you’re telling yourself. I started imagining firemen who show up to protect me. Only there was no fire to put out, and their intense activity — bright lights blazing, sirens blaring, motors roaring, their shouts as they dragged heavy hoses around — only made matters worse. I needed to send the firemen home.

I grabbed a notebook and began to draw, something I hadn’t done for decades. I needed to see these firemen. Only I found myself drawing Viking warriors instead. They were standing on our driveway in their helmets and armour, looking up at me on the porch.

“It’s okay, you can go home now, I’m fine!” I said in a comic strip balloon. “No problem!”

One was disappointed.

“I was hoping to rescue you,” he said glumly. “On the other hand I really am quite tired from working so hard.” He decided he’d enjoy a rest. Another wanted to have a beer before he crashed. They all started yawning.

From that day on I imagined firemen or Vikings when the pain came on, and told them to relax and stand down. It didn’t always work, but it tended to calm down the pain considerably, and sometimes it would stop it altogether.

All this was further evidence that I could “unlearn” my pain.

When I’d first mentioned Neil Pearson’s methods to my brother, four years ago, he’d seemed skeptical. Now though when I told him how I’d “changed my brain”, he said enthusiastically:

“Good for you!”

“I know you may not believe in Pearson’s methods, but…”

“No!” he said firmly. “I do!”

If my brother’s mind was changing, what about the thinking of other medical professionals? Was our medical system beginning to catch up with this new approach to pain as a mindbody disorder? A Google search brought me to a TED X talk by University of British Columbia brain researcher Lara Boyd.

“Everything we do changes our brains,” she said, emphasizing that the key was to practise.

I vowed to keep practising. That morning was challenging. The pain would grip one glute, then the other, but I threw one technique in the online program after another at it: breath awareness, a breathing exercise using a Sanskrit word, gentle yoga, and watching educational videos about the science of pain. By noon I had no pain, and this state of bliss lingered through lunch.

The pain free periods were getting longer.

I continued to work the Life is Now program, and at the same time, to read Steve Ozanich’s book, “The Great Pain Deception”. Pearson’s program gave me a way to structure my recovery. Ozanich’s story strengthened my courage and my resolve.

It made me wonder two things: is this title accurate? , and is there more than one way to apply contemporary neuroscience to exercise interventions?

When I first began working in interdisciplinary pain management programs in the late ‘80’s, the dominant treatment protocol was informed by what I think were cognitive behavioural therapy principles. Patients were told that they were not to perform movement or exercises contingent on their pain. On ‘good pain days’ they were told to stick with the plan, and on ‘bad pain days’, they were told to stick with plan. Patients were also told that the way they think about their pain needed to change. Not only were they to control negative thinking, but they also were to stop negative thoughts and learn to think less about their pain. Given that similar instructions are included in this article, I wonder if it should be more accurately titled, “Applying contemporary neuroscience and cognitive behavioural therapy principles in exercise interventions for chronic spinal pain: treatment protocol”. Then again, maybe the manner in which they are suggesting we apply neuroscience to movement and exercise therapy is just different from my understanding. Science and patients make it clear that there is no one path we can follow when helping people with this complex human experience we call pain. Yet, I believe we need to think about what we read, teach and think.

Pain neuroscience tells us that pain is not an accurate indication of tissue health, nociception, injury, … This reminds me of many of the physical examination techniques we use in musculo-skeletal-neurological assessments. Typically, no single test can provide accurate evidence of the structural or physiological state of the tissues. All tests have sensitivity and specificity related to a ‘condition’. Yet we do not ignore these tests because they are not accurate. We decide that the best solution is to combine the assessment results with those of other assessment techniques in order to come to an informed conclusion.

Pain neuroscience tells us that there is a relationship between pain and the organism’s determination of safety and danger (I am using “organism” because this process is reliant on far more than the brain, yet I think there must be a better word). If I understand this neuroscience properly, when there is a determination of danger, processes and systems and the organism will become protective. All these processes involve both the typically-automatic and the conscious cognitive-emotional aspects of our existence. Concurrent with pain, we often experience other protective processes, such as tight muscles and stiffness, rapid breathing or breath-holding, fear of injury, and anxiety about more pain in the future. Does neuroscience suggest ignoring these protective responses as an adaptive strategy producing better long-term outcomes? Do we have neuroscience evidence that not paying attention to pain while moving promotes positive adaptive changes in the person, in physiology or in the brain? Or is this a strategy informed by cognitive behavioural principles.

Pain neuroscience tells us that people in pain who frequently endure increased pain (flare-ups) during activity or subsequent to increased activity are as likely to sensitize their nervous systems as those who are fear avoidant. In other words, ignoring pain may not be the best advice for all people based on neuroscience.

Science tells us that the individual in pain has no direct sensory evidence of the state of their tissues – only the ability to experience the organism’s interpretation of the state of the tissues, body and mind. Does this mean that pain science informs us to ignore how we experience our body, as a therapeutic intervention? Or does it suggest that since there is no single ‘sensory experience’ that would accurately guide us to how much we should move or exercise, therefore we should listen to multiple ‘sensory experiences’ instead in an attempt to make better judgments? Similar to our guidance to an individual with rheumatoid arthritis during a flare-up, in which our education includes using pain, heat, redness and swelling as guides for activity (because no one sign/symptoms is accurate enough), couldn’t pain neuroscience inform us to attend to multiple aspects of existence as a guide to moving with more ease? It might be difficult at first, and many might need practice to be more discerning of their experiences of body, breath, mind and pain, yet many people report that by ‘listening to’ ease of breath, tension in their body, their pain, and their mind (“am I safe”, and “will I be okay later”), they can be more successful at moving with more ease, and recovering function.

Pain neuroscience suggests that we experience less pain when there is greater evidence of safety. As an alternative to making exercise time-contigent for people in pain, can we start by considering that increased muscle tension, breath holding or rapid shallow breathing, fear of injury, and fear of a flare up might all add to the credible evidence of danger? When we succeed in building a strong caring relationship with our patients, then our pain education can potentially convince the patient that they are truly safe. This new belief about pain and attitude towards movement as recovery will likely reduce other protective responses such as tension, altered breath, and negative cognitions and emotions.

Pain neuroscience suggests there is more than one path. We can use much more than knowledge and cognitions as a source of changing the organism’s determination of danger.

If you have experienced intense lasting pain, imagine for a moment that you are about to apply a mechanical load to your body that previously worsened your pain, creating a multi-day flare of hypersensitivity and little ability to find peace, even in sleep. You trust your clinician, and you have taken the time to acquire deep understanding of pain neuroscience. You know that you are physiologically safe. You know that there is a large buffer between increased pain and injury. Yet you are experiencing your protective systems on high alert as you begin the movement. Your cognitive learning has not yet generalized to previous kinesthetic learning. Is ignoring your experiences of heightened protection your only adaptive option? Certainly, if you can fully shut down these thoughts there is likely to be greater determination of safety. Yet, what about using other aspects of your existence to further decrease evidence of danger? Might some people be more able to make the necessary cognitive shift, when those cognitions are supported by other compatible inputs to the brain? Would some find it more effective to shift the organism’s determination of safety when they are also regulating of their breath, their body tension, and/or emotions?

Neuroscience informs that pain is a biopsychosocial experience. Changing cognitions is therefore one strategy to enhance movement and exercise therapies. This same logic extends beyond cognitive strategies, to include enhancing an individuals ability to move with more ease by altering sensory signaling from the musculo-skeletal system, respiratory system, cardiovascular system, autonomic nervous system, emotions, relationships, workplace and societal forces.

Neuroscience supports a biopsychosocial view of all therapeutic interventions. As such, a logical inference is that movement and exercise can be considered as paths to changing cognitions. Movement and exercise have a role in the changes we observe in self efficacy, in hopelessness and helplessness and therefore catastrophic thinking, in body schema and body image, and in emotions such as grief, anxiety and depression.

Maltlief et al provide an instructive beginning to discussions of integrating pain neuroscience and movement therapies for people in pain. They have also infused cognitive behavioural principles into their protocol. As we move forward, applying science to get past our Cartesian and dualistic views, we have much to consider – including whether any of our protocols are effective for long-term outcomes, and whether any particular strategy can be learned and effectively used by other clinicians.

Many people have experienced that practicing yoga helps recover moving with more ease and decreases pain. These improvements are typically attributed to physiological changes such as strength, flexibility and posture, or to psychological changes such as decrease anxiety or lightening of depression. Yet, pain and changes in it subsequent to practicing yoga should be considered from many more perspectives.

Clearly pain is not easy to understand. Ask a group of people to complete the sentence, “Pain is …. (blank)”, and you will receive many answers. Some say it is a noun, some a verb, and others an adjective, yet all agree it is a moving target and life-changing experience.

One unique way that some contemplate pain is that it can be a story. As professionals, we might share inspiring and surprising stories of patients who have found their way to yoga because of pain. Sometimes we share stories of people who having found more peace in life through yoga and are finally able to regain movement and purpose in life. These suggest that we should consider not only the story of pain, but pain as a story.

Scientists tell us that when we feel pain, the brain has concluded that there is evidence of danger and that we need to change our behavior. As such, the experience of pain is both an alarm system and a sophisticated protection system. Yet when we look deeper into out personal experiences of pain, we realize that pain has an intensity, a location in the body, and we can usually describe its qualities. Our experience of pain also has many other aspects – we feel changes in muscle tension, breathing patterns, thoughts and emotions. And pain impacts our ability to move and interact with others. It can even change our perception of our body so that it feels bigger, smaller, or even less defined. Putting this all together, we can consider that it is as if a complex multi-faceted story has been created, all with the purpose of protection. After an injury, and as time passes, this story typically changes. It becomes less powerful and less important. We move from being able to attend to little else in our life but the pain. It’s almost as if the story gets old and tired, or as if the pain story is old news and we don’t need to attend to it anymore. Other times though, the story grows in strength, like a tragedy unfolding inside us.

Whether the story loses power or gains, it is important to see that the story is changing, and therefore it is changeable.

We can change the pain by changing the story. But how do we do this rewriting?

The rituals, techniques and practices of yoga provide us with mechanisms for rewriting aspects of the story, and sometimes to rewrite the whole thing. We can notice if the story is playing over and over, and learn to influence how often it plays. We can explore the details of the story, or in other words we can practice awareness and insight of the story. For many, this practice of noticing without trying to change is a powerful change process all by itself. We can gain more awareness of how the story is impacting each aspect of our existence, and take the time to be curious about how changing each aspect of our existence can impact the story. What happens when we breathe differently, hold our body differently, or change our thoughts or emotions? And what happens when we continue to practice? Yoga, like all movement and contemplative practices is a skill. How long can we continue to influence and make changes to the story?

Each time we look inward we can consider the story of our pain from new points of view. And each time we look inward, we have the opportunity to rewrite a part of the story. As one of my students wondered, “If pain is a product of my brain or some aspects of me, and I have influence over every aspect of me, then maybe it’s time to start rewriting the story ?”

What story arises when you try to move in the face of pain? Does the story include tightening of your body and muscles, shortening or holding of your breath, running from the pain sensations, negative thoughts and unhelpful emotions? Could you change the story by changing any of these aspects of your existence? And can you see the importance of continued practice, and persistence?

Scientists explain aspects of chronic pain through explanations of neuro-immune plasticity. They are able to show that when pain persists there are relatively permanent changes in neural and immune systems and cells. The problem is that attempting to changes these back takes effort, practice and patience. Above all, these neuro-immune changes typically do not change back all by themselves. Our efforts are required, to rewrite this story and to create lasting ‘positive’ neuro-immune changes.

Most pain stories include difficulties moving the body. And most include disruptions of breathing and muscle tension. For many of us when the story has continued to play for some time, it includes changes in our feelings of competence, difficulties in letting go of tension, being out of balance in life, being disconnected from our life’s purpose, or feeling less courageous than usual. These can all be part of the story created by the brain to protect us. And as such, if we direct our yoga practices (or any contemplative movement practice) towards these, we can rewrite the story.

Remember, pain is real. Discussing it as a story is not intended to suggest that it was intentionally created, or all in your head. Pain changes every aspect of us. It is far more complex than what many have been teaching us. When it lasts a short period of time, we can forget about it and let it resolve on its own. When it persists, we need to consider it from many other perspectives.

Yoga allows us a safe place, rituals and gentle practices to explore our pain story. It can allow us to rewrite our stories – a little at a time. We can change how our breathing, and muscle tension, and mind, and heart respond to movement. Each time we find a new way to move with more ease, the story shifts away from a tragedy, towards the happy ending we desire.